During the Carney era, DHSS spending grew by $778.4M, or 35.1%, to almost $1.8B. Some of this spending increase could be blamed on COVID-19, but that doesn't explain all of it. Medicaid costs (a subset of DHSS spending) grew at 28.9% -- large, to be sure, but not the main driver.
Comparing the two budget years, the department has grown its headcount by 284 people, but more critically, multiple divisions and offices were reallocated in the budget, making one-to-one comparisons difficult.
In short, DHSS is a behemoth agency incorporating Medicaid, Public Health, Animal Welfare, Substance Abuse, Temporary Assistance for Needy Families, Visually Impaired, etc. Given the wide assortment of services, needs, and structures, it is easy to expect that the bureaucracy associated with DHSS continues to grow with few efficiency gains implemented. This is the most likely reason for the outsized cost increases.
A significant concern is fraud. DHSS itself expects 40,000 to 60,000 Medicaid recipients will lose their coverage now that COVID-19 has receded, creating an opportunity for large-scale scams. In addition, the Attorney General sought to pause opioid grants due to fraud concerns, but DHSS ignored her concerns and issued $45M in grants anyway.
Technology is a BIG LOSER
In state government, you can forget about technological innovation. Neither Zoom nor AI exist in the "government world." Spending in the Delaware Department of Technology & Information (DTI) accounts for just over $106M, or only 1.3% of the budget. By comparison, the department called "Executive," a random assortment of offices that should be put into other departments (e.g., Criminal Justice Council, Housing, Statistical Analysis, etc.), grew 105.5% to $588.5M, accounting for 13.3% of state spending-a lot of money with lax of oversight for dozens of miscellaneous agencies.
State government could use a specific effort to bring automation and more efficient service delivery via computer technology.
Recommendation
Delaware state government needs to improve efficiency. With the excess billions of dollars coming in from COVID-19 and many administration leadership roles staffed by the same people for over a decade, the state is sloppy and expensive.
CRI recommends that Delawareans ask all the gubernatorial candidates how they expect to handle making government work more efficiently.